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PTSD: Sleep Disturbances After 9-11 Attacks

9-11 Attacks Making Sleep Difficult

Events Of 9-11 Took Their Toll On Americans' Sleep

Sleep Problems Following a Crisis

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Posted On: April 02, 2002          Updated On: April 02, 2002
© Terence T. Gorski, 2001

9-11 Attacks Making Sleep Difficult

AP Science Writer 

APRIL 02, 01:43 ET 

WASHINGTON (AP) — Almost seven out of 10 Americans experienced some sleep disturbance after the terrorist attacks of Sept. 11, says a survey that also shows almost half the people say their sleep is only fair or poor.

A poll conducted by the National Sleep Foundation found the death and destruction of the terrorist attacks caused about 69 percent of Americans to have some insomnia during the period immediately after Sept. 11. A survey a year earlier found only 51 percent experiencing insomnia.

James Walsh, president of the foundation and a sleep researcher at St. Luke's Hospital Sleep Medicine & Research Center in Chesterfield, Mo., said Sept. 11 affected the sleep poll figures for all of 2001 and suggests a generalized increase in sleeplessness.

``Last year's figure was 51 percent for insomnia, and this year it is 58 percent for the entire year,'' said Walsh. ``All the terrorist activities are one of the major stresses in our lives now.''

The poll found that women tended to lose more sleep after Sept. 11 than did men. For women, 78 percent reported some insomnia, compared with 59 percent for men.

More poor sleepers also are seeking pharmaceutical help.

``Other studies have shown that the use of sleeping pills and the use of antidepressants went up for a couple of months,'' Walsh said. ``That reflects the overall anxiety in the country.''

People who always have been poor sleepers are now having even more trouble, Walsh said.

More people who do not sleep well, he said, ``are now attributing it to these worries than to other things.''

The sleep survey is based on polling of 1,010 randomly selected adults, interviewed by telephone between Oct. 1 and Dec. 10 last year. The margin of error for the poll is 3 percent.

Asked to rate the quality of their sleep in the days after Sept. 11, 47 percent of those polled said theirs was only fair or poor. This compares to 27 percent in polling not linked to Sept. 11.

The poll found that fewer people than last year are getting eight hours sleep, the recommended minimum. The mean sleep per night of those polled was 6.9 hours, compared with seven hours last year, and only 30 percent said they got eight or more hours, compared with 38 percent last year.

Young people are more apt to wake up tired or to have trouble falling asleep than are the elderly, the poll found. Among people aged 18 to 29, 49 percent said they awoke unrefreshed from sleep, and 33 percent said they had trouble falling asleep. For those aged 30 to 64, the numbers were 41 and 24 percent. For those 65 and over, only 25 percent felt tired upon awakening, while just 19 percent said they had trouble falling asleep.

Walsh said the fall-to-sleep recommendations of the foundation have not changed since Sept. 11. He said people need to limit caffeine, avoid naps late in the day, don't depend on alcohol for sleep and keep a regular bedtime routine and schedule.

Also, said Walsh, people need to set aside time in the day to worry instead of taking their blues to bed with them. 

``We actually assign worry time to people so they don't lie in bed at night worrying about things,'' he said. ``They can say tell themselves `I've already thought about that, and I have a plan of action.' These techniques can reduce anxiety when you're lying in bed at night.''

The poll also found an increase in irritability and anger among sleepyheads.

``In sleep deprivation, one of the first things that changes is a person's mood,'' Walsh said. ``They become more irritable and short-tempered.''

Walsh said the poll also suggested that people favor more sleep for professions that are important to safety, such as doctors, pilots and truck drivers. 

When asked the maximum time that doctors and pilots should work daily, the majority wanted to limit it to 10 hours.

On the Net: National Sleep Foundation:



Marcia Stein, p: 202-347-3471 x205

WASHINGTON, DC, November 19 -- The events of September 11 had a dramatic impact on the quality of Americans' sleep, according to a new poll by the National Sleep Foundation (NSF), which found nearly one-half of respondents reporting symptoms of insomnia as they tried to sleep in the nights immediately following the attacks. Women had more difficulty sleeping than men during this time, the poll results show.

The results suggest a significantly greater number of sleep problems following September 11 compared with the period preceding the 9/11 events.

Sleep problems frequently experienced by those polled in the immediate aftermath of September 11 included: difficulty falling asleep (44%), awakenings during the night (48%), and waking up feeling unrefreshed (50%). Nearly two out of five respondents (39%) said they awakened too early and couldn't get back to sleep. Each of these sleep problems is characterized as a symptom of insomnia by sleep experts.

Women had substantially more sleep problems than men in the days immediately following the terrorist attacks, according to the NSF poll findings. Female respondents were more likely than males to say they frequently had difficulty falling asleep (50% vs. 37%), while two out of five male respondents said they never had difficulty falling asleep during that period compared to females (40% vs. 26%).

More than one-half of the female respondents said they were frequently awake a lot during the night (59% vs. 38%), and nearly one-half of the females polled said they woke up too early and couldn't get back to sleep (47% vs. 30%).

On the other hand, nearly twice as many of the males polled said they were never awake a lot during the nights following the attacks compared to female respondents (33% vs. 18%). Almost one-half (46%) of male respondents said they never experienced waking up too early and being unable to fall back asleep; only about one-fourth (28%) of female respondents said they never experienced these problems during this period.

Stress or anxiety were by far the leading causes of frequent night awakenings for poll respondents in the wake of September 11. Among those who reported an inability to sleep through the night, 71 percent attributed the problem to stress or anxiety, while fear (33%), depression (32%), and bad dreams (23%) were other reasons cited.

In spite of their sleep problems, however, more than one-half of respondents (51%) rated the quality of their sleep as good or better immediately after September 11, while 47 percent said their sleep was fair or poor. Surprisingly, there was no statistical difference by region in the quality of people's sleep, according to the NSF poll. In fact, respondents in the Northeast were more likely to say their sleep was 'very good' or better during this time than those in the Midwest, South, and West (31% vs. 15% vs. 20% vs. 28%).

By contrast, when asked about the quality of their sleep over the entire past year, nearly three-fourths (74%) of those polled said their sleep was good to excellent while 28 percent said it was fair or poor during this time. Respondents reported significantly fewer symptoms of insomnia throughout the past year than they did in the nights immediately following September 11. One fourth of those polled said they frequently had difficult falling asleep during the past year, and the same number reported waking up too early and not getting back to sleep. Also in the past year, more than one-third of respondents (37%) reported frequent awakenings during the night, while four in ten (40%) said they woke up feeling unrefreshed in the past year.

WB&A Market Research conducted the telephone survey of 993 adults over the age of 18 between October 1 and November 13. The questions are part of the National Sleep Foundation's 2002 Sleep in America poll, which will be released in April. The margin of error is plus or minus 3.1 percent.

 For more information, go to "Sleep Problems Following a Crisis"

See NSF's Web site for a complete list of NSF Public Opinion polls.

The National Sleep Foundation is a nonprofit organization dedicated to improving public health and safety by achieving understanding of sleep and sleep disorders, and supporting public education, sleep-related research, and advocacy.

National Sleep Foundation

Sleep Problems Following a Crisis

At the National Sleep Foundation, our heartfelt concerns are with all Americans and people around the world who are suffering as a result of the tragic events that occurred starting on September 11, 2001.

As a result of pain, grief, and stress, many people experience sleep disruptions, including trouble falling asleep, staying asleep, waking early or having nightmares. People may also feel excessively sleepy during the day or at times when they expect to be alert. Often these are manifestations of underlying distress. Nonetheless, lost sleep or excessive daytime sleepiness (EDS) contribute to feelings of adversity, can seem like one more "loss of control" and add to the burdens which in their totality can be overwhelming. Lost sleep also robs us of the opportunity to restore ourselves physically, emotionally and even cognitively.

That is why the National Sleep Foundation has put together the following information to help people address their need for sleep, sleep problems and how to maximize the sleep they get during trying times. Our materials include links within our site and to others as well as resources that can help you. Topics include:

Coping with Sleep and Stress: A Conversation with a Sleep Expert

Sleep: Why It Matters

Sleep Problems:

bulletNightmares and Sleep Terrors
bulletExcessive Daytime Sleepiness and Fatigue

Getting Help

Other Resources


Addiction - A Biopsychosocial Model

Denial Management Counseling (DMC)

Relapse Prevention Counseling (RPC)

Relapse Prevention Therapy (RPT)

Addiction-Free Pain Management (APM)

Food Addiction

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